IMPORTANT POINT
Once the State in its magnanimity adopts a decision that the medical bills in their entirety in connection with the heart diseases shall be reimbursed, the authorities of the State being bound thereby are obligated to comply therewith.

JUDGMENT

S.B. Sinha, J.—

1. Leave granted.

2. The sole respondent was an employee of the State of Haryana. He has since retired. He was serving in the ‘Health Department’ of the State having joined services on 26.11.1961. He retired on 7.9.1988 on health grounds.

3. He suffered an heart attack on 15.8.2002. He was treated in the Post Graduate Institute of Medical Sciences and Research, Chandigarh. He underwent a bye-pass surgery at Fortis Heart Institute and Multi-Speciality Hospital, Mohali. It is on the recognized panel of the hospitals of the State of Haryana. He submitted a bill for a sum of Rs.1,87,907.65 towards medical expenses borne by him for its reimbursement.

Relying on or on the basis of a circular issued by the State of Haryana dated 30.11.1993, the Department sanctioned payment for a sum of Rs.1,62,298/- only.

4. Aggrieved by the said order, the respondent filed a writ petition before the High Court of Punjab and Haryana. The said writ petition was allowed, holding:

“We have heard learned Counsel for the parties.

Shri W.R. Dua, learned counsel for the petitioner drew our attention to the Punjab Services (Medical Attendance) Rules 1940, as applicable to the Haryana employees/pensioners and the instructions issued by the Haryana Government vide circular letter No. HD.HR. No.2/82/98-IHB-III dated 31.10.2002 to show that Fortis Hospital, Mohali has been recognized by the Haryana Government for the treatment of Haryana Government employees/Pensioners/Family Pensioners. He then referred to the instructions issued vide letter dated 11.8.1992 (Annexure P.5/A) to show that heart disease has been treated as one of the chronic ailments and argued that the petitioner is entitled to full medical reimbursement in terms of the instructions issued by the Government vide letter dated 25.8.2003.

Learned Assistant Advocate General could not put forward any tangible argument to controvert the submissions of Shri W.R. Dua.

Having considered the entire matter, we are convinced that the Petitioner is entitled to reimbursement of the entire expenses incurred by him in his treatment at Fortis Hospital, Mohali and the decision of the Respondents to pay only 75% thereof is legally unsustainable.”

5. Mr. Manjit Singh, learned counsel appearing on behalf of the State, contended that the High Court committed a serious error in so far as it failed to give effect to the circulars issued by the State laying down the norms for reimbursement of the medical bill.

6. Mrs. Nanita Sharma, learned counsel appearing on behalf of the respondent, on the other hand, urged that the heart disease having been considered to be one of the chronic diseases, the circular letter dated 28.5.2003 would prevail.

7. The Commissioner and Secretary of the state of Haryana, Health Department, by a circular dated 30.11.1993 directed as under :

“I have been directed to invite your attention to the Haryana Government letter No.2/296/86-H.R.II-III dated 19.11.1985 (sic 1986) and to say that the decision for granting recognition to Nivedic Prosyek Centre Daulat Singh Zirakpur (Punjab) Batra Hospital New Delhi for taking special treatment to serving Haryana Govt. officers/officials/pensioners/family pensioners and members of their family and dependants subject to the condition that the conditions that the officers/officials/pensioners who would undergo for treatment in those approved institutions will get reimbursement at the rates of All India Institute of Medical Sciences (AIIMS) New Delhi/PGI. The 75% of the excess expenditure in comparative to AIIMS will also be re-imbursed and the rest of 25% will be borne by the claimant himself. If a Patient avails extra comfort as single room instead of double occupy room facilities, as such the whole expenditure will be borne by the claimant himself.

2. This has the concurrence of the finance department vide their memo No.56/80A/86-6 Fin. Deptt. TT/229-1532-2297 dated 13.10.93.

3. This order will come into force from the date of issue